[Effects of metoprolol on perioperative cardiovascular events in patients with risk or at high risk for coronary artery disease undergoing non-cardiac surgery].
OBJECTIVE
To assess the effects of metoprolol on perioperative cardiovascular events in patients with risk or at high risk for coronary artery disease (CAD) who were to undergo non-cardiac surgery.


METHODS
102 patients with definite CAD or at high risk for CAD who were to undergo selective non-cardiac surgery were randomized to 2 equal groups: Group A (blank control group) and Group B given metoprolol orally or intravenously from 2 h before surgery to 30 days after surgery. The dosage of metoprolol was adjusted according to the blood pressure and heart rate. The changes of peri-operative heart rate (HR), level of creatine kinase (CK)-MB, cardiac events such as unstable angina pectoris (UAP) and myocardial infarction (MI), death, and stroke were recorded.


RESULTS
The HR values, intra-operative and 6 h, 1 d, and 2 d after operation of Group B were all significantly lower than those of Group A (all P < 0.05). One patient from each group had MI. One case of death and two cases of strokes occurred in Group A. The occurrence rate of at least one cardiovascular event were 9.8% in Group A (5/51) and 2.0% in Group B (1/51) without significant difference between these 2 groups (P > 0.05).


CONCLUSIONS
Metoprolol reduces the incidence of postoperative severe cardiovascular episodes in patients with risk of or at high risk for CAD undergoing non-cardiac surgery.
Yang
Xue-yuan
XY
Department of Anesthesiology, First Hospital of Peking University, Beijing 100034, China. yang81211978@sohu.com
Wu
Xin-min
XM
Wang
Shi
S
Wang
Qi
Q
D000368:Aged; D002318:Cardiovascular Diseases / Q000209:etiology / Q000517:prevention & control*; D003324:Coronary Artery Disease / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008790:Metoprolol / Q000627:therapeutic use*; D009203:Myocardial Infarction / Q000209:etiology / Q000517:prevention & control; D019990:Perioperative Care; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control; D012307:Risk Factors; D013514:Surgical Procedures, Operative / Q000009:adverse effects / Q000379:methods; D013565:Sympatholytics / Q000627:therapeutic use; D016896:Treatment Outcome
D013565:Sympatholytics; D008790:Metoprolol